Williams Astrid-Jane, Paramsothy Ramesh, Wu Nan, Ghaly Simon, Leach Steven, Paramsothy Sudarshan, Corte Crispin, O'Brien Claire, Burke Catherine, Wark Gabrielle, Samocha-Bonet Dorit, Lambert Kelly, Ahlenstiel Golo, Wasinger Valerie, Dutt Shoma, Pavli Paul, Grimm Michael, Lemberg Daniel, Connor Susan, Leong Rupert, Hold Georgina
Department of Gastroenterology, Liverpool Hospital, Liverpool, New South Wales, Australia.
Ingham Institute, Liverpool, New South Wales, Australia.
BMJ Open. 2021 Feb 16;11(2):e042493. doi: 10.1136/bmjopen-2020-042493.
Crohn's disease and ulcerative colitis are common chronic idiopathic inflammatory bowel diseases (IBD), which cause considerable morbidity. Although the precise mechanisms of disease remain unclear, evidence implicates a strong multidirectional interplay between diet, environmental factors, genetic determinants/immune perturbations and the gut microbiota. IBD can be brought into remission using a number of medications, which act by suppressing the immune response. However, none of the available medications address any of the underlying potential mechanisms. As we understand more about how the microbiota drives inflammation, much interest has focused on identifying microbial signals/triggers in the search for effective therapeutic targets. We describe the establishment of the Australian IBD Microbiota (AIM) Study, Australia's first longitudinal IBD bioresource, which will identify and correlate longitudinal microbial and metagenomics signals to disease activity as evaluated by validated clinical instruments, patient-reported surveys, as well as biomarkers. The AIM Study will also gather extensive demographic, clinical, lifestyle and dietary data known to influence microbial composition in order to generate a more complete understanding of the interplay between patients with IBD and their microbiota.
The AIM Study is an Australian multicentre longitudinal prospective cohort study, which will enrol 1000 participants; 500 patients with IBD and 500 healthy controls over a 5-year period. Assessment occurs at 3 monthly intervals over a 24-month period. At each assessment oral and faecal samples are self-collected along with patient-reported outcome measures, with clinical data also collected at baseline, 12 and 24 months. Intestinal tissue will be sampled whenever a colonoscopy is performed. Dietary intake, general health and psychological state will be assessed using validated self-report questionnaires. Samples will undergo metagenomic, transcriptomic, proteomic, metabolomic and culturomic analyses. Omics data will be integrated with clinical data to identify predictive biomarkers of response to therapy, disease behaviour and environmental factors in patients with IBD.
Ethical approval for this study has been obtained from the South Eastern Sydney Local Health District Research Ethics Committee (HREC 2019/ETH11443). Findings will be reported at national and international gastroenterology meetings and published in peer-reviewed journals.
ACTRN12619000911190.
克罗恩病和溃疡性结肠炎是常见的慢性特发性炎症性肠病（IBD），会导致相当高的发病率。尽管疾病的确切机制尚不清楚，但有证据表明饮食、环境因素、基因决定因素/免疫紊乱与肠道微生物群之间存在强烈的多向相互作用。IBD可以使用多种药物缓解，这些药物通过抑制免疫反应起作用。然而，现有的药物均未针对任何潜在的发病机制。随着我们对微生物群如何驱动炎症的了解越来越多，人们的兴趣主要集中在寻找微生物信号/触发因素，以确定有效的治疗靶点。我们描述了澳大利亚IBD微生物群（AIM）研究的建立，这是澳大利亚首个IBD纵向生物资源库，它将通过经过验证的临床仪器、患者报告的调查以及生物标志物，识别纵向微生物和宏基因组信号并将其与疾病活动相关联。AIM研究还将收集已知会影响微生物组成的广泛人口统计学、临床、生活方式和饮食数据，以便更全面地了解IBD患者与其微生物群之间的相互作用。
AIM研究是一项澳大利亚多中心纵向前瞻性队列研究，将在5年内招募1000名参与者；500名IBD患者和500名健康对照。在24个月期间每3个月进行一次评估。每次评估时，自行采集口腔和粪便样本以及患者报告的结局指标，同时在基线、12个月和24个月时收集临床数据。每当进行结肠镜检查时，都将采集肠道组织样本。使用经过验证的自我报告问卷评估饮食摄入、总体健康状况和心理状态。样本将进行宏基因组学、转录组学、蛋白质组学和代谢组学分析。组学数据将与临床数据整合，以识别IBD患者对治疗的反应、疾病行为和环境因素的预测生物标志物。
本研究已获得悉尼东南部地方卫生区研究伦理委员会（HREC 2019/ETH11443）的伦理批准。研究结果将在国内和国际胃肠病学会议上报告，并发表在同行评审期刊上。
ACTRN12619000911190。
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